This study explores the global burden of female infertility across 204 countries and 21 regions from 1990 to 2021. The population-based study analyzed was conducted using data from the Global Burden of Disease 2021. We assessed age-standardized prevalence rate (ASPR), age-standardized incidence rate, disability-adjusted life years rate, and trends via average annual percent change, with projections to 2035 using the Bayesian age-period-cohort model. The outcomes revealed that female infertility sustained a global rise in ASPR (0.66% annually) and disability-adjusted life years (0.68% annually), driven by population growth and aging. Notably, while the 35 to 39 age group exhibited the highest prevalence, the 20 to 29 age group showed the fastest growth rate (average annual percent change = 1.04%), signaling a younger-onset trend. Socioeconomic disparities were prominent: low-middle sociodemographic index regions experienced the steepest ASPR increases (1.23% annually), contrasting with high sociodemographic index areas. During 2019 to 2021, ASPR stabilized, potentially linked to COVID-19-related population shifts rather than direct biological effects. Projections indicate a persistent burden, with ASPR reaching 6458.26/100,000 by 2035. These findings underscore the urgent need for targeted interventions addressing socioeconomic inequities, younger demographic risks, and sustainable reproductive health policies to mitigate the escalating global challenge of female infertility.

Pneumoperitoneum and the Trendelenburg position during laparoscopic hysterectomy (LH) increase intra-abdominal and intrathoracic pressure, reducing lung compliance and predisposing patients to atelectasis. This study evaluated the effects of alveolar recruitment maneuver (RM) on intraoperative hemodynamics, lung compliance, and oxygenation.

Following ethics committee approval, 70 American Society of Anesthesiologists I-II patients scheduled for elective LH were enrolled prospectively. Standard anesthesia monitoring was supplemented with radial arterial cannulation to assess cardiac output via arterial waveform analysis. After anesthesia induction and tracheal intubation, patients were randomly divided into 2 groups: Group I (RM) and Group II (Control). Group I underwent multi-step RM twice intraoperatively. Hemodynamic parameters, arterial blood gases, and compliance measurements were recorded throughout surgery. Durations of surgery, anesthesia, and postanesthesia care unit stay were documented. Pulmonary complications were assessed on postoperative days 1 and 3.

Demographics and durations of anesthesia, surgery, and postanesthesia care unit stay were comparable between groups. Inotropic requirements and intraoperative fluid volumes were similar. Heart rate remained comparable; however, mean arterial pressure, cardiac index, and stroke volume index were significantly higher in Group I, while stroke volume variation, pulse pressure variation, and systemic vascular resistance index were significantly lower (P < .001). These hemodynamic changes were pronounced at peak RM pressure. Group I exhibited significantly higher dynamic lung compliance, PaO2, and PaO2/FiO2 ratios (P < .001). Overall, RM was associated with transient, hemodynamically tolerable changes alongside improved lung mechanics and oxygenation.

Alveolar RM improved intraoperative lung compliance and oxygenation during LH without causing clinically significant hemodynamic instability. Incorporating RM into intraoperative management of laparoscopic procedures appears beneficial. These hemodynamic changes were transient and were not associated with an increased vasopressor requirement or clinically relevant hemodynamic instability.

Sexual violence is a major public health and medico-legal concern, but many cases remain unreported. During the coronavirus disease 2019 pandemic, social isolation, restricted services, and psychosocial stress raised concerns about changes in reporting. This study aimed to analyze and compare patterns of officially recorded sexual violence in Lithuania before and during the pandemic. A retrospective, registry-based, repeated cross-sectional study used data from the Departmental Register of Criminal Offences on recorded sexual offenses in Lithuania during 2018 to 2021. Cases were divided into pre-pandemic (2018-2019) and pandemic (2020-2021) periods. Data were analyzed using Microsoft Excel and R 4.3.2 with Rcmdr 2.9.2 (R Foundation for Statistical Computing). Categorical variables were compared using chi-square or Fisher exact tests, with Monte Carlo simulation where appropriate; quantitative variables using the t-test or Mann-Whitney U test; and population-based recorded case rates using Poisson rate comparison. A total of 736 recorded sexual violence cases were analyzed. Recorded cases decreased from 451 before the pandemic to 285 during the pandemic, and the recorded case rate decreased from 8.01 to 5.07 per 100,000 population (rate ratio 0.63, 95% confidence interval 0.54-0.74, P < .001). Rape was the most frequently recorded offense type. Most recorded victims were female, and most cases involved suspects known to the victim. The proportion of minors among recorded victims slightly increased, but not significantly (64.8% vs 69.0%, P = .255), while the population-based recorded victim rate among minors decreased. Victims were significantly younger than suspects (P < .001). Recorded alcohol involvement slightly decreased, but not significantly. Among cases with documented physical-damage information (48.1%), non-severe health impairment was recorded more frequently during the pandemic period (3.95% vs 18.08%, P < .001). In Lithuania, officially recorded sexual violence cases and their population-based rate decreased during the coronavirus disease 2019 pandemic, while the main recorded victim-suspect profile remained broadly similar. Most recorded cases involved female victims and suspects known to the victim, and minors constituted a large proportion of recorded victims. Among cases with documented physical-damage information, non-severe health impairment was more frequently recorded during the pandemic period.

Mycoplasma pneumoniae is an important cause of community-acquired pneumonia in children, and severe M pneumoniae pneumonia (SMPP) is frequently complicated by pleural effusion, yet specific risk factors for effusion in this population remain incompletely defined. In this retrospective observational study, 121 hospitalized children with SMPP admitted between January 2022 and June 2023 were enrolled and classified into a pleural effusion group (n = 32) and a non-pleural effusion group (n = 89) based on chest radiography. Demographic data, past medical history, clinical manifestations, laboratory indices, and radiologic findings were extracted from electronic records. Group comparisons were performed using independent-samples t tests and χ2 tests, and factors associated with pleural effusion were evaluated by univariate and multivariate logistic regression. Children with pleural effusion exhibited longer fever duration, higher peak temperature, faster respiratory rate, more frequent chest indrawing, and more extensive radiologic involvement than those without effusion. They also had higher white blood cell counts, neutrophil predominance, lower lymphocyte percentages, and significantly elevated C-reactive protein, procalcitonin, erythrocyte sedimentation rate, lactate dehydrogenase, and D-dimer, together with slightly lower serum albumin. Multivariate analysis identified prolonged fever duration, increased respiratory rate, and elevated C-reactive protein as independently associated with pleural effusion in children with SMPP. These readily available clinical indicators may help clinicians identify patients at higher risk of pleural effusion and facilitate closer monitoring and timely imaging evaluation.

Obstructive sleep apnea (OSA) is linked to fasting plasma glucose, high-density lipoprotein cholesterol, and body mass index. However, the association between OSA and the ln[(fasting plasma glucose)/(high-density lipoprotein cholesterol)] × body mass index (FHB) index: calculated as ln(FPG/HDL-C) × BMI: has not been extensively investigated in US adults. This research aims to investigate whether the FHB index is associated with the risk of self-reported OSA symptoms among US adults. The analysis utilized National Health and Nutrition Examination Survey datasets collected during the 2005 to 2008 and 2015 to 2018 survey cycles. Weighted multivariable regression and curve fitting were applied to explore the FHB index-OSA correlation, while subgroup and sensitivity analyses were conducted to evaluate the consistency of this relationship. Among 7414 study subjects, 3694 reported symptoms of OSA. Curve fitting showed a nonlinear positive relationship of the FHB index for OSA risk (P for nonlinearity <.001), with an identified threshold of 25.84. Below this value, each 1-unit increase in the FHB index was linked to a 5.2% increase in OSA risk (odds ratio [OR] = 1.052; 95% confidence interval [CI]: 1.009-1.096). Above this value, each 1-unit increase was linked to a 2.6% increase (OR = 1.026; 95% CI: 1.022-1.031). When the FHB index was analyzed as a categorical variable, individuals in the third tertile of the FHB index had odds of OSA that were 211.9% higher than those in the first tertile (OR = 3.119; 95% CI: 2.675-3.635). Subgroup and sensitivity analyses confirmed the robustness of this association. This cross-sectional study revealed a nonlinear positive relationship between the FHB index and self-reported OSA among US adults. The FHB index may serve as a novel and convenient candidate marker for identifying individuals at high-risk of OSA, meriting further investigation. However, before considering clinical application, these findings require validation through longitudinal studies.

Obstructive sleep apnea (OSA) severity classification relies primarily on the Apnea-Hypopnea Index (AHI), which quantifies event frequency but does not capture event duration or hypoxemic burden. We examined whether serum prolactin and total antioxidant status (TAS) show differential correlation patterns with frequency- versus duration-based polysomnographic parameters, potentially reflecting distinct pathophysiological mechanisms. This cross-sectional study enrolled 55 participants (controls: n = 12, AHI < 5; mild/moderate OSA: n = 22, 5 ≤ AHI < 30; severe OSA: n = 21, AHI ≥ 30) undergoing overnight polysomnography. Fasting serum prolactin and TAS were measured. Spearman correlations examined biomarker associations with AHI (numerically equivalent to the Respiratory Disturbance Index in this cohort), oxygen desaturation index, total apnea-hypopnea duration, longest apnea duration, and lowest oxygen saturation; P-values were adjusted for multiple testing using the Benjamini-Hochberg false discovery rate procedure. Both prolactin (22.7 ± 9.8 vs 14.7 ± 7.2 vs 12.7 ± 7.3 ng/mL, P = .007) and TAS (1.181 ± 0.068 vs 1.122 ± 0.065 vs 1.111 ± 0.057 mmol/L, P = .021) decreased progressively across severity groups. TAS correlated with event frequency (AHI: r = -0.419, q = 0.013) but not with longest apnea duration (r = -0.223, q = 0.103), while prolactin correlated with both frequency (AHI: r = -0.360, q = 0.017) and duration parameters (longest apnea duration: r = -0.288, q = 0.044). However, when TAS and prolactin correlations were compared directly for each parameter using Steiger Z test for dependent correlations, none of the differences reached statistical significance (all P ≥ .65), indicating that this apparent divergence reflects differing significance thresholds rather than a formally confirmed difference in association strength. A positive correlation between prolactin and lowest oxygen saturation did not retain significance after false discovery rate correction (q = 0.053) and is considered exploratory. TAS and prolactin show descriptively different correlation patterns with frequency- and duration-based polysomnographic parameters; however, direct statistical comparison did not confirm these differences as significant, and the findings should be regarded as hypothesis-generating rather than confirmed evidence of distinct pathophysiological mechanisms. Larger, independent cohorts are needed to formally test whether these biomarkers diverge in their associations with OSA severity dimensions.

The neurological and neuropsychiatric manifestations of long COVID remain incompletely understood. Reactivation of latent herpesviruses has been proposed as a contributing mechanism, but human herpesvirus 7 (HHV-7) has received limited attention despite its neurotropic potential. We conducted a retrospective analysis of HHV-7 polymerase chain reaction (PCR) results in 30 patients (18 women and 12 men; age range, 21-55 years) with a neurological/neuropsychiatric long COVID phenotype tested within 24 months of SARS-CoV-2 infection at R.E.D. Laboratories SA, Belgium. HHV-7 positivity was compared with a historical pre-COVID-19 laboratory reference cohort comprising 320 diagnostic tests performed from 2012 to 2019. HHV-7 positivity was 29.1% (93/320; 95% CI, 24.4-34.3%) in the historical reference cohort and 76.7% (23/30; 95% CI, 59.1-88.2%) in the neurological/neuropsychiatric long COVID cohort. The between-cohort difference was significant using a two-sided Fisher's exact test (p < 0.000001). All six patients tested within the first 12 months were HHV-7-positive. HHV-7-positive patients frequently reported neuropsychiatric symptoms, and in one longitudinal index case, viral load tracked self-reported symptom severity. In this patient-initiated retrospective study, HHV-7 positivity was substantially more frequent in the long COVID cohort than in the historical reference cohort. These findings are hypothesis-generating and support prospective investigation of HHV-7 in neurological and neuropsychiatric long COVID.

Respiratory syncytial virus (RSV), influenza viruses, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain major causes of seasonal respiratory morbidity, yet their contemporary temporal relationships and age-specific dynamics are insufficiently characterized. We analyzed nationwide Polish surveillance data for the 2024/25 and 2025/26 epidemic seasons, reporting the weekly infection burden per 100,000 population, both overall and by age group (0-4, 5-19, 20-59, and ≥60 years). The seasonal magnitude, peak timing, peak width, normalized temporal trajectories, and age-specific lead-lag patterns were compared. In both seasons, respiratory virus circulation followed the same temporal sequence: COVID-19 activity increased first and peaked in September, followed by influenza in January/February and RSV infections in February/March. Mean weekly burden was lower in 2025/26 for all three infections, by 22.0% for influenza, 19.5% for COVID-19, and 16.0% for RSV, with the between-season difference reaching statistical significance only for influenza (p = 0.0024). Age-stratified analyses likewise showed significantly lower influenza burden in 2025/26 across all age groups, whereas for COVID-19, a significant reduction was observed only among adults aged ≥60 years; no significant between-season differences were found for RSV in any age group. Despite the lower mean influenza burden, the 2025/26 season produced a higher, narrower influenza peak, while the COVID-19 and RSV peaks were lower. Temporal trajectories were highly concordant between seasons for influenza (Spearman's Rs = 0.975) and RSV infections (Rs = 0.956) and to a lesser extent for COVID-19 (Rs = 0.883). Age-specific temporal trajectories were strongly concordant across age groups, particularly for influenza (pairwise same-week correlations (Rs = 0.972-0.987 in 2024/25 and Rs = 0.963-0.992 in 2025/26). Influenza activity was largely synchronous across age groups, with pediatric peaks occurring approximately 1 week earlier, whereas COVID-19 and, to a lesser extent, RSV showed more consistent pediatric leads relative to adults aged ≥60 years (approximately 1-2 weeks). However, for all three infections, the ascending phase became apparent earlier in children aged 0-4 years than in adults, suggesting that peak timing alone may underestimate the pediatric lead. These findings support integrated, age-stratified surveillance and indicate that preventive strategies, particularly updated COVID-19 vaccination, should be timed to precede the early-autumn rise in transmission.

Whole-blood transcriptomic profiling can capture systemic immune-response alterations associated with COVID-19 and may support host-response-based classification. However, evidence regarding the discriminatory value of targeted immune-gene panels remains limited, and in small, high-dimensional datasets, the timing of feature selection may substantially affect model performance and interpretation.

This study aimed to evaluate whether NanoString Human Immunology Panel profiles could distinguish COVID-19 from healthy-control measurements and to compare full-dataset feature selection (FDFS) with leave-one-out cross-validation (LOOCV)-embedded feature selection (LEFS).

Publicly available E-MTAB-8871 data comprising 579 genes and 32 whole-blood transcriptomic profiles were analyzed. The dataset included 22 longitudinal COVID-19 measurements obtained from three participants and 10 measurements obtained from 10 healthy controls. Elastic Net regularization was used for feature selection. Random Forest, XGBoost, and LightGBM classifiers were evaluated using sample-level LOOCV. Model performance was assessed using threshold-dependent, discrimination, and probability-based metrics. A separate exploratory LightGBM model was analyzed using SHapley Additive exPlanations (SHAP) to characterize feature contributions.

FDFS identified a fixed 40-gene set, whereas LEFS selected a mean of 42 genes per fold (range: 40-47). LightGBM correctly classified all 32 measurement-level profiles (derived from 13 unique participants: 10 healthy controls and three longitudinally sampled COVID-19 participants) in both frameworks, achieving area under the receiver operating characteristic curve (ROC-AUC) and area under the precision-recall curve (PR-AUC) values of 1.000 and Brier scores of 0.005 and 0.006 in the FDFS and LEFS frameworks, respectively. Random Forest achieved accuracies of 0.969 and 1.000, whereas XGBoost achieved an accuracy of 0.969 in both frameworks. SHAP analyses consistently identified AICDA as the dominant contributor to model predictions, followed by ARHGDIB.

This exploratory analysis showed that targeted NanoString immune-response profiles contained a compact transcriptomic signal capable of distinguishing COVID-19 from healthy-control measurements within the analyzed dataset. These findings provide proof-of-concept evidence of internal measurement-level discrimination. However, because the COVID-19 profiles consisted of repeated measurements from only three participants, sample-level LOOCV did not constitute independent participant-level validation. External validation in larger cohorts comprising independently sampled participants is required. Given that the COVID-19 arm comprised only three independent participants, these biological findings should be regarded as hypothesis-generating and require validation in substantially larger independent cohorts.

We developed and evaluated two pentaplex real-time fluorescent PCR assays (Panel 1/Panel 2) for simultaneous detection of ten ovine pathogens. Panel 1 targets respiratory pathogens: Bluetongue virus (BTV), Foot-and-mouth disease virus (FMDV), Schmallenberg virus (SBV), Peste des petits ruminants virus (PPRV), and Sheep pox virus-Goat pox virus (SPPV-GTPV). Panel 2 targets reproductive pathogens: Border disease virus (BDV), Brucella spp. (Bru), Toxoplasma gondii (T. gondii), Chlamydia abortus (C. abortus), and Caprine arthritis-encephalitis virus (CAEV). Each panel uses six fluorescent channels for detection. Validation using reference pathogens and plasmids confirmed that the assay can effectively detect the target pathogens. The Limit of Detection at 95% probability (LOD95) ranged from 2.9 to 6.1 copies/μL for all targets, with correlation coefficients (R²) greater than 0.99. The intra-assay and inter-assay coefficients of variation (CV) were less than 1.5% at both high (10⁵ copies/μL) and low (10³ copies/μL) template concentrations. Cross-reactivity tests demonstrated high specificity with no cross-detection among different targets. Validation using 620 clinical samples collected from multiple provinces in China showed strong concordance with reference methods. This multiplex assay provides a rapid, sensitive, specific, and reliable tool for the differential detection and surveillance of major ovine respiratory and reproductive pathogens.